单心动周期三维超声评价房间隔缺损患者封堵术前后右室容积和功能  

Evaluation of the changes of right ventricular volume and function by using single beat real-time 3-D echocardiography in patients with atrial septal defect before and after percutaneous closure

作　　者：陶文鸿[1] 郭其凤[2] 曹永政[1] 曾炜[1] 

机构地区：[1]贵州遵义医学院附属医院超声科,563099 [2]贵州遵义医学院附属医院心电图科,563099

出　　处：《介入放射学杂志》2014年第5期388-391,共4页Journal of Interventional Radiology

摘　　要：目的采用单心动周期三维超声评价房间隔缺损(ASD)患者封堵术前后右室容积和功能变化。方法 2011年7月—2013年10月对45例单纯继发孔型ADS患者行介入封堵术。将患者分为ASD无肺动脉高压组28例和ASD合并肺动脉高压组17例。应用单心动周期三维超声结合术中右心导管检查测定两组患者封堵术前后的右室舒张末容积(RVEDV)、右室收缩末容积(RVESV)、右室每搏量(RVSV)、右室射血分数(RVEF)、肺动脉收缩压(PASP)和肺动脉平均压(mPAP),并计算右室心输出量(RVCO)。结果术后两组患者的RVEDV、RVESV、RVSV及RVCO均显著减低,与术前相比差异均有统计学意义(P<0.05)。无肺动脉高压组的RVEF低于术前(P<0.05),而伴肺动脉高压组与术前比较差异无统计学意义(P>0.05)。术后伴肺动脉高压组的肺动脉压明显减低(P<0.05)。结论单心动周期三维超声能快速、准确评估右室容积和功能;ASD患者封堵术后右室容积减低;无肺动脉高压患者封堵术后右室功能减低;伴肺动脉高压患者封堵术后肺动脉压降低而右室功能无明显变化。Objective To evaluate the changes of right ventricular （RV） volume and function by using single beat real- time three dimensional （3- D） echocardiography in patients with atrial septal defect （ASD） before and after percntaneous closure. Methods During the period from July 2011 to Oct. 2013, a total of 45 patients with pure ostium secundum defect were admitted to authors＇ hospital to receive percutaneous transeatheter closer. The patients were divided into ASD without pulmonary hypertension （PH） group （group A, u = 28） and ASD with PH group （group B, n = 17）. By using 3-D echocardiography and right cardiac catheterization, the right ventricular end-diastolic volume （RVEDV）, right ventricular end- systolic volume （RVESV）, right ventricular stroke volume （RVSV）, right ventricular ejection fraction （RVEF）, right ventricular cardiac output （RVCO）, pulmonary artery systolic pressure （PASP） and the mean pulmonary artery pressure （mPAP） were determined before and after the percutaneous transcatheter closer. The results were compared between the two groups. Results After the treatment a statistically significant reduction in RVEDV, RVESV, RVSV and RVCO were seen in all patients （P 〈 0.05）. In group A, RVEF decreased significantly after ASD closure when compared with that determined before transeatheter closer （P 〈 0.05）, while no significant reduction in RVEF was seen in group B （P 〉 0.05）. Pulmonary artery pressure （PAP） decreased significantly in group B after ASD closure when compared with that obtained beforetranscatheter closer （P 〈 0.05）. Conclusion Single beat real-time 3- D echocardiography is a newly- developed technique. This technique can quickly and accurately assess the right ventricular volume and function. Right ventricular volume willdecrease after ASD closer. In ASD patients without PH the right ventricular function will decrease after ASD closer, while in ASD patients with PH the right ventricular function shows no changes

关 键 词：房间隔缺损 介入封堵术 实时三维超声心动图 右室容积和功能 

分 类 号：R541.1[医药卫生—心血管疾病]